Image-based radiation therapy quality assurance

ABSTRACT

Systems, methods, and computer software are disclosed for acquiring images during delivery of a radiation beam, the images capturing at least a portion of a shape representative of a radiation field generated by a radiation delivery system that includes a radiation source configured to deliver the radiation beam.

RELATED APPLICATION(S)

This application is a continuation of U.S. patent application Ser. No. 16/999,700, filed Aug. 21, 2020, which is a continuation-in-part of and claims priority to and the benefit of U.S. patent application Ser. No. 16/925,205, filed Jul. 9, 2020, and issued as U.S. Pat. No. 11,378,700 on Jul. 5, 2022, titled “Scintillator-Based Radiation Therapy Quality Assurance,” which claims priority to U.S. Provisional Application No. 62/872,646, filed Jul. 10, 2019, titled “Scintillator-Based Radiation Therapy Quality Assurance,” the disclosures of which are hereby incorporated by reference.

DESCRIPTION OF THE RELATED ART

Radiation therapy can be utilized in the treatment of diseases, for example, by delivering a dose of radiation to kill or to inhibit growth of a cancerous tumor. Devices to deliver radiation therapy can include, for example, radioisotopes, heavy ion accelerators and linear accelerators that generate a photon beam directed at a tumor site. To irradiate a tumor while minimizing exposure to nearby healthy tissues, a radiation beam can be shaped by a collimating device, for example, a multileaf collimator (MLC). Multileaf collimators include a number of movable leaves that can be positioned to create a shaped aperture (e.g., shaped the same as the tumor, from the vantage point of the radiation beam).

Radiation therapy quality assurance can be performed to verify the proper operation of one or more components of a radiation therapy delivery system, for example, verifying the positioning of MLC leaves.

SUMMARY

Systems, computer program products, and methods are disclosed for determining a shape of a radiation field generated by a radiation delivery system that includes a radiation source configured to deliver a radiation beam. An implementation of a system and/or computer program product that determines the shape of the radiation field includes a non-transitory, machine-readable medium storing instructions which, when executed by at least one programmable processor, cause the at least one programmable processor to perform operations comprising: acquiring images during delivery of a radiation beam, the images capturing at least a portion of a shape representative of a radiation pattern generated by a radiation delivery system that includes a radiation source configured to deliver the radiation beam.

In some variations, the images can be acquired from a camera aimed at a computer monitor displaying the shape representative of the radiation pattern. The camera can be mounted in a fixed relationship to the computer monitor by mounting to the computer monitor itself or to another location nearby. For example, the camera can be fixed to the computer monitor so that the camera will be at an angle of between 1 and 10 degrees relative to a screen of the computer monitor.

In other variations, the operations can further include receiving conversion information entered by a user after measuring a geometric relationship between the camera and the computer monitor. The operations can also include determining conversion information based on utilizing imaging of markers placed at known locations.

In still other variations, the operations can further include determining conversion information that establishes a relationship between image intensity and delivered dose.

Also, in some variations, the operations can include applying an edge detection algorithm to a radiation pattern present in the images, the edge detection algorithm determining at least one edge of the radiation pattern corresponding to a leaf of a multi-leaf collimator; and determining a leaf position based at least on a location of the determined edge. The operations can also include comparing the leaf position during delivery of the radiation beam with a planned leaf position, the comparing utilized in radiation therapy quality assurance.

In other variations, the acquiring can be performed by screen capture of a computer monitor displaying the shape representative of the radiation pattern.

In an interrelated aspect, a method can include placing a graticule with markers that have known dimensions between the markers; initiating delivery of a radiation beam; imaging the graticule with the radiation detector during delivery of the radiation beam; acquiring images, the images capturing at least a portion of the graticule; and determining a conversion factor based on at least the known dimensions of the graticule and the acquired images.

Implementations of the current subject matter can include, but are not limited to, methods consistent with the descriptions provided herein as well as articles that comprise a tangibly embodied machine-readable medium operable to cause one or more machines (e.g., computers, etc.) to result in operations implementing one or more of the described features. Similarly, computer systems are also contemplated that may include one or more processors and one or more memories coupled to the one or more processors. A memory, which can include a computer-readable storage medium, may include, encode, store, or the like, one or more programs that cause one or more processors to perform one or more of the operations described herein. Computer implemented methods consistent with one or more implementations of the current subject matter can be implemented by one or more data processors residing in a single computing system or across multiple computing systems. Such multiple computing systems can be connected and can exchange data and/or commands or other instructions or the like via one or more connections, including but not limited to a connection over a network (e.g., the internet, a wireless wide area network, a local area network, a wide area network, a wired network, or the like), via a direct connection between one or more of the multiple computing systems, etc.

The details of one or more variations of the subject matter described herein are set forth in the accompanying drawings and the description below. Other features and advantages of the subject matter described herein will be apparent from the description and drawings, and from the claims. While certain features of the currently disclosed subject matter are described for illustrative purposes in relation to particular implementations, it should be readily understood that such features are not intended to be limiting. The claims that follow this disclosure are intended to define the scope of the protected subject matter.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are incorporated in and constitute a part of this specification, show certain aspects of the subject matter disclosed herein and, together with the description, help explain some of the principles associated with the disclosed implementations. In the drawings,

FIG. 1A is a diagram illustrating a perspective view of a simplified exemplary radiation delivery system in accordance with certain aspects of the present disclosure,

FIG. 1B is a diagram illustrating a side-sectional view of the simplified exemplary radiation delivery system of FIG. 1A in accordance with certain aspects of the present disclosure,

FIG. 2 is a diagram illustrating a perspective view of a simplified exemplary multileaf collimator shaping a radiation field in accordance with certain aspects of the present disclosure,

FIG. 3 is a diagram illustrating views of a simplified exemplary radiation pattern at a scintillator in accordance with certain aspects of the present disclosure,

FIG. 3A is a diagram illustrating an exemplary system utilizing a camera to capture images of a radiation pattern displayed on a computer monitor in accordance with certain aspects of the present disclosure,

FIG. 4 is a diagram illustrating an end-perspective view of a simplified exemplary scintillator fixed in an orientation that is not perpendicular to the radiation beam axis in accordance with certain aspects of the present disclosure,

FIG. 5A is a diagram illustrating a perspective view of a simplified exemplary scintillator and camera fixed in a supporting structure in accordance with certain aspects of the present disclosure,

FIG. 5B is a diagram illustrating a perspective view of a simplified exemplary scintillator and camera fixed in a supporting structure that is open on a top and bottom portion in accordance with certain aspects of the present disclosure,

FIG. 6 is a diagram illustrating a perspective view of a simplified exemplary combined radiotherapy and medical imaging system in accordance with certain aspects of the present disclosure,

FIG. 7 is a diagram illustrating a side-sectional view of the simplified exemplary combined radiotherapy and medical imaging system of FIG. 6 in accordance with certain aspects of the present disclosure,

FIG. 8 is a diagram illustrating an end-perspective view down the bore of the simplified exemplary combined radiotherapy and medical imaging system of FIG. 6 , showing exemplary scintillators and cameras in accordance with certain aspects of the present disclosure,

FIG. 8A is a diagram illustrating an exemplary sequence of how radiation patterns and images thereof may appear at different stages of the disclosed systems, in accordance with certain aspects of the present disclosure,

FIG. 9 is a diagram illustrating an exemplary method of determining leaf positions of a multileaf collimator in accordance with certain aspects of the present disclosure,

FIG. 10 is a diagram illustrating an exemplary geometric method of determining a leaf position of a multileaf collimator from a radiation pattern in accordance with certain aspects of the present disclosure.

DETAILED DESCRIPTION

Radiation therapy quality assurance is a field that includes, among other things, determining whether a radiation delivery system is functioning properly and providing the prescribed radiation dose to a patient as detailed in a radiation therapy treatment plan. While many radiation delivery systems include their own functionality for displaying output and diagnostic metrics, radiation therapy quality assurance products can obtain independent measurements of what the radiation delivery system is providing.

As used herein, the term “radiation delivery system” can include various components needed to generate, direct and control a radiation therapy beam. For example, a radiation therapy system can include a radiation source (e.g. a linear accelerator, particle beam source, etc.), a gantry (fixed or rotating), a collimator (to shape the radiation reaching the patient), imaging equipment (to image prior to or during therapy), and the like.

As part of quality assurance, the operation of various components of the radiation delivery system can be independently assessed. Examples of such operations can include, for example, verifying the output of the radiation source, the position of a rotating gantry, the configuration of a multileaf collimator (e.g., determining its leaf positions), etc. The present disclosure describes, among other things, systems, software, and methods for determining collimator configurations based on the analysis of radiation patterns that emerge after a radiation beam passes through the collimator.

FIGS. 1A and 1B depict an exemplary radiation delivery system 100. This exemplary system is an open (or “C-arm”) type system that includes a linear accelerator (e.g., element 110 in FIG. 1B) working with an RF source 150, a multileaf collimator 120, and a rotatable gantry 130. In this exemplary system, the linear accelerator and multileaf collimator are mounted within the rotatable gantry to allow radiation beam 160 to be delivered along beam axis 170 to a patient 10 at multiple angles. FIG. 1A also depicts an accessory tray 140 that can permit the mounting or positioning of hardware or devices between the radiation source and the patient. As described further herein, the technologies of the present disclosure can be used with radiation delivery systems such as the exemplary system depicted in FIGS. 1A and 1B, as well as with other types of radiotherapy systems.

When performing radiation therapy quality assurance, one element of the radiation therapy device that can be assessed is the multileaf collimator (e.g., through verifying the collimator's leaf positions). One method for MLC configuration verification may involve examining the shape of the radiation field delivered to the patient by a radiation delivery system 100 including a radiation source (e.g., linear accelerator 110) configured to deliver a radiation beam 160. As shown in the simplified example of FIG. 2 , a radiation field 210 can be shaped by blocking some portions with the leaves 220 of a multileaf collimator 120 to form an aperture 230. The portion of the radiation field that passes through the aperture will then proceed to the patient to deliver a dose of radiation in the desired shape. As used herein, the term “radiation field” can refer to radiation before or after being shaped by a collimator.

Scintillating materials may be used to determine the shape of a radiation field emerging from a multileaf collimator. “Determining the shape” can include determining the overall shape, determining particular MLC leaf positions (which provides information regarding the shape), etc.

“Scintillators,” as discussed herein, are understood to include any material that, when hit by radiation, emit radiation (e.g., particle or photon) that can be detected (for example, by a camera). Scintillators include materials that absorb incoming radiation and then re-emit a portion of the absorbed energy in the form of light. It should be noted that when the term “light” is used herein, it is intended to include radiation within, or not within, the visible spectrum (for example, scintillators that emit infrared or other types of radiation are contemplated). Examples of scintillators can include plastic scintillators (such as Li6 plastic scintillators or polyethylene naphthalate), luminophores, crystal scintillators, phosphorescent materials, etc. As used herein, a “camera” can be any device that can detect radiation (e.g., light) coming from a scintillator. Examples of cameras can include CCD cameras, photodiodes, photomultiplier tubes, etc.

The top portion of FIG. 3 illustrates a simplified example of a scintillator 310 receiving a radiation beam 160 from radiation delivery system 110, after it passes through a multileaf collimator 120.

The lower portion of FIG. 3 illustrates a simplified example of a system for detecting a radiation pattern 320 from scintillator 310 using a camera 330. The radiation pattern 320 is related to the shape of the aperture formed by the multileaf collimator (as used herein, “radiation pattern” refers to the pattern present at the scintillator as it emits radiation/light after exposure to a radiation field).

Analysis of the images or signals acquired by the camera from the scintillator's radiation patterns can provide estimates of leaf positions of the multileaf collimator, independent of leaf position information that may be provided by the radiation delivery system itself.

With reference to FIG. 3 a , the disclosure herein relating to obtaining and utilizing a shape of a radiation pattern at a scintillator also applies to obtaining images by, for example, using a camera 330 or screen capturing software to obtain images from a computer monitor 340 displaying information from a radiation detector 180 (e.g., an EPID). Camera 330 can have a field of view 332, which may be different than the extents of the computer monitor. As used herein, and depicted in FIG. 3 a , the captured images (e.g., a video file generated by the camera or screen capture software) are referred to as images 334 and can be processed by image processing module 336.

During treatment or quality assurance, personnel may observe at computer monitor 340 the radiation pattern at the radiation detector 180 in terms of an accumulated amount of radiation. Such monitors can display the shape of the radiation pattern at any resolution (i.e., possibly, but not necessarily, the same resolution as the active surface of the radiation detector). For example, the radiation detector could have 1000×2000 detector elements but displayed at the computer monitor with 2000×4000 pixels, thus corresponding to four pixels at the computer monitor per detector element at the radiation detector. In some implementations, to provide a reference as to the extent of the displayed computer monitor image, the computer monitor may display a bounding box 360 of known size, scale, or other indication of the actual size of the radiation pattern at the radiation detector. Also, the shape can be displayed to also communicate the intensity of radiation. For example, the shape can have pixels with different colors reflecting different intensities or accumulations of radiation. As described further herein, both tilted scintillators or computer monitors can be utilized to provide information about the radiation reaching the radiation detector, with such information usable to derive collimator positions, dose calculation, fluence maps, etc.

The present disclosure describes, among other things, technologies utilizing scintillators to verify collimator leaf positions. However, contrary to what is common in the art, the present disclosure describes certain embodiments that utilize a scintillator that is tilted, so as to not be perpendicular to the axis of the radiation beam. Also contrary to the art, certain embodiments disclose a scintillator system with a very shallow angle between the camera and the scintillator. For example, disclosed systems may be configured such that the angle between a planar scintillator and the camera's line of sight is less than 10 degrees.

One implementation of the disclosed technology for determining at least a portion of a shape of a radiation field is depicted in FIG. 4 . The figure illustrates a simplified representation of a radiation source 402 and a series of collimators (an X-axis jaw 410, a Y-axis jaw 420, and a multileaf collimator 120). Also illustrated is a patient 10 lying on a couch 430 such that the patient is hit by radiation beam 160 after its passes through the collimators. An accessory tray 140 is also depicted between the collimators and the patient couch.

The exemplary system of FIG. 4 can also include a scintillator 440 and a camera 450 configured to acquire images of light emitted by the scintillator during delivery of the radiation beam. As shown in FIG. 4 , the scintillator and camera system can be configured to be located between the radiation source and a patient couch, thus functioning as an entrance detector.

It is contemplated that scintillator 440 may include a planar sheet of scintillating material or may include a curved sheet of scintillating material that may, for example, be oriented to have its convex surface facing toward the camera. In some embodiments, scintillator 440 may be sized to be large enough to cover the largest radiation field the radiation delivery system can deliver (at the location of the scintillator). In other embodiments, scintillator 440 may be more compact and may be smaller than the largest radiation field the system can deliver at the location of the scintillator, yet still sufficient for performing some measure of quality assurance.

As illustrated in FIG. 5A, scintillator 440 and camera 450 can be fixed in a support structure 510. The support structure 510 may then be configured to be mounted to a radiation delivery system so that the scintillator will be struck by the radiation treatment beam.

The scintillator and camera are preferably fixed to the support structure in a manner that sets a specific desired geometric relationship between the scintillator and camera. The exemplary embodiment depicted in FIG. 5A illustrates a simplified framework where the scintillator is located within the support structure and the camera is located and configured to view one side of the scintillator (e.g., its bottom surface). It is contemplated, however, that the camera may be placed in a position to view the top surface of the scintillator or that more than one camera may be used.

In some embodiments, the scintillator and camera can be fixed to the support structure so that when the support structure is mounted to the radiation delivery system, the scintillator is not perpendicular to an axis of the radiation beam. FIG. 4 illustrates such an example of a scintillator 440 not being perpendicular to the axis 170 of radiation beam 160. When referring herein to a scintillator being oriented so that it is not perpendicular to an axis of the radiation beam, such refers to an orientation that is purposefully not perpendicular (i.e., as opposed to an orientation that may slightly deviate from an intended perpendicular positioning).

Some embodiments may have the scintillator fixed to the support structure so that the scintillator will be at an angle of between 80 to 89 degrees or between 91 and 110 degrees relative to the axis of the radiation beam when the support structure is mounted to the radiation delivery system. In other embodiments, the scintillator can be at an angle of between 84 and 88 degrees or between 92 and 96 degrees relative to the axis of the radiation beam when the support structure is mounted to the radiation delivery system. While the exemplary embodiment depicted in FIG. 4 shows a tilt in the Y direction, it is contemplated that a similar tilt could be implemented in the X direction or in both the X and Y directions.

In some embodiments, such as the one depicted in FIG. 5A, camera 450 and scintillator 440 can be fixed to support structure locations that maximize the angle between the camera and the scintillator. In such examples, the camera may be at one end of the support structure, as depicted, or may be in a corner of the support structure, or may even be located outside the perimeter of the support structure. Such embodiments can be beneficial in that the resolution of the radiation pattern imaged by the camera can be increased as compared to smaller angles where the radiation pattern is viewed more edge-on.

The design of the support structure can be substantially open above and/or below the scintillator to reduce or eliminate material that may attenuate the radiation therapy beam. Alternatively, the scintillator and the camera can be substantially enclosed by the support structure (for example, to prevent dust from accumulating on the scintillator or to protect it from damage or scratching). In such embodiments, the top portion and/or bottom portion of the support structure may be designed to provide only minimal attenuation of a radiation beam. For example, the top and/or bottom portion may be a layer of thin plastic or glass that causes only slight attenuation of the radiation beam.

The example depicted in FIG. 5A can represent a support structure 510 that substantially encloses the scintillator (i.e., is closed on all sides), but FIG. 5A is also intended to depict an example where the support structure 510 is merely a frame for mounting the scintillator and camera—with all the sides and the top/bottom being open.

FIG. 5B Illustrates another exemplary embodiment in which the top portion and bottom portion of support structure 520 are open to allow light or other radiation unobstructed access to/through the scintillator, but where the support structure 520 also includes closed structural portions on its sides.

The present disclosure contemplates support structures that are constructed to include any combination of open or closed or transparent/translucent top, bottom or side materials.

Some embodiments of the present disclosure can enable the use of a visible light source (e.g., a tungsten or any sort of atomic lamp, or a white light source) to check the shape of a collimator aperture while the scintillator/support structure is in place. In such embodiments, the support structure can include translucent or transparent portions, which may be, for example, the top portion, bottom portion, or any portion(s) that form the sides of the support structure. It is contemplated that any combination of portions of the support structure may be translucent or transparent. Similarly, the scintillator may also be translucent or transparent. Such translucent or transparent support structure portions and/or scintillators can allow formation of a pattern at a target location (e.g., at the isoplane) corresponding to the shape of a collimator aperture when a light source shines light through the collimator aperture onto the scintillator and/or supporting structure portion. The present disclosure contemplates that any embodiments herein (not just planar scintillator embodiments) can incorporate transparent or translucent support structure portions and/or scintillators.

As used herein, the term “transparent” means that light corresponding to the shape of the collimator aperture is able to pass through without significant distortion, resulting in a pattern that can be accurately related to the shape of the collimator aperture. Similarly, as used herein, the term “translucent” means that light is able to pass, but there may be some distortion or dimming of the light and the resulting pattern corresponding to the shape of the collimator aperture. In embodiments where a translucent material is used, it is contemplated that degree of distortion will not be prohibitive of providing a pattern that can be utilized in radiation therapy quality assurance for determining the shape of a collimator aperture. Also, it is contemplated that the transparent or translucent material described herein can have any degree of attenuation of light. For example, a transparent scintillator may attenuate 50% of light but still allow a sharp (though dimmer) pattern to be formed at the target location. According to the type of application desired, translucent or transparent scintillators can have a polyvinyltoluene base, optionally including some fraction of lead (e.g., approximately 2%—appropriate for x-ray dosimetry), etc.

In some embodiments, the support structure can be configured to be mounted to the radiation delivery system at an accessory tray disposed between the radiation source and a patient couch. For example, a linear accelerator may have an accessory tray or slot into which the support structure may be mounted. It thus contemplated herein that when reference is made to a support structure being “configured to be mounted,” this can include, for example, being configured in a way to be removably mounted (e.g., structurally designed to slide into an accessory tray slot or specifically sized to fit within the tray). Support structures herein are also contemplated to be configured to be mounted by virtue of more permanent structures such as the provision of screw holes or other fastening accessories to aid in mounting to a particular portion of a radiation delivery system.

In certain embodiments, the scintillator(s) and camera(s) can be fixed to the support structure in a manner so that the whole assembly fits entirely within an accessory tray.

The support structure mounting, in conjunction with specific fixation therein of the scintillator and camera can result in a tilted scintillator orientation with regard to the axis of the radiation beam. For example, mounting the support structure into a linac accessory tray that is perpendicular to the axis of the radiation beam, when the scintillator is fixed at an angle within the supporting structure, results in the scintillator being tilted with regard to the axis of the radiation beam.

In contrast to the scintillator/camera systems described above for a C-arm type radiation delivery system, the present disclosure contemplates alternative embodiments for implementation with radiation delivery systems having a bore, for example, a radiation delivery system combined with an imaging system such as an Mill. FIG. 6 shows a simplified example of such a system 600 that includes first and second magnet housings 602 and 604 separated by gap region 612. A radiation source 606 can be mounted to a gantry adjacent to or in a gap region 612. A patient can be positioned on couch 614 inside bore 616 of the magnet so that the gantry can cause rotation of radiation source 606 around the patient.

FIG. 7 depicts a cross-sectional view of the exemplary system shown in FIG. 6 . Such a system can be used to image a target region 702 (e.g., a volume and/or area within a patient), while radiation source 606 emits radiation 704 for patient treatment. Also shown is a multileaf collimator 710 for shaping the radiation beam directed toward the patient. The system illustrated in FIGS. 6 and 7 is only one example of a radiotherapy system having a bore that is compatible with embodiments of the present disclosure. Implementations of the technologies herein may also be used with other types of radiotherapy systems that include a patient bore.

Scintillators that are shaped or configured for radiotherapy systems having a bore may be utilized in certain implementations. For example, as shown FIG. 8 , scintillator 810 can be mounted to radiation delivery system 600 such that scintillator 810 substantially follows the contour of a bore 616 of a radiation delivery system 600. As noted above with regard to FIGS. 6 and 7 , the bore may be part of an MRI-guided radiotherapy system. “Substantially following the contour of a bore” is understood to include, for example, following the internal surface of the bore or having generally the same contour as the bore but a slightly larger or smaller diameter, etc.

The scintillator may be a continuous sheet of scintillating material or may be comprised of multiple sheets. The example of FIG. 8 illustrates an exemplary scintillator having multiple curved sheets of scintillating material, specifically, eight curved sheets, each covering 45 degrees of the bore. In other implementations, the scintillator may be made up of a number of planar sheets of scintillating material. For example, the configuration shown in FIG. 8 could instead be comprised of eight planar sheets, meeting at their edges. It is contemplated that any number of curved or planar sheets can be implemented, in any feasible combination, to cover a desired portion of the bore and they can be located at any radial distance from the axis of the bore.

While the scintillator can extend around the entire circumference of the bore, it is not essential that it do so. For example, the scintillator can cover any degree or angular measure of the bore (e.g., 270 degrees, 180 degrees, 90 degrees, 45 degrees, etc.) and may be constituted of any number of sheets (e.g., ten sheets covering 27 degrees each, 18 sheets covering 10 degrees each, etc.).

As described in further detail herein, mounting the scintillator to the radiation delivery system may include, for example: mounting the scintillator directly to a portion of the radiation delivery system such as the gantry, the linac, the MLC, etc.; mounting the scintillator to the bore of an imaging system associated with the radiation delivery system (e.g., an MM for an MM-guided radiation therapy system); and, mounting the scintillator indirectly, for example, mounting the scintillator to a supporting structure that can in turn be mounted to portions of the overall system (e.g., RT device, MM, etc.).

In some embodiments, the scintillator can be mounted so it is at an angle to the radiation beam or the scintillator can be mounted so that at least one portion of the scintillator remains perpendicular to axis 830 of the radiation beam when the radiation source 606 is controlled to move around the bore. For example, in instances where the radiation beam axis 830 is radial and the scintillator is curved to be concentric with the bore, at least one portion of the scintillator (e.g., where axis 830 intersects the scintillator) would be perpendicular to axis 830.

One or more cameras configured to acquire images of light emitted by the scintillator during delivery of the radiation beam can be utilized. Similar to the previously-described embodiments, these may be mounted so as to have a shallow angle between the scintillator and the camera. For example, the cameras can be configured to be mounted at an angle of greater than 0 and less than 10 degrees relative to the scintillator. In other embodiments, the cameras may be mounted to result in angles of 10-20, 20-30, 30-40, 40-50 or 50-60 degrees between the scintillator and the line of sight of the camera.

Cameras can be placed on the bore at various locations so they are able to view at least a portion of the scintillator. The cameras can be small so as to provide minimal intrusion into the inner volume of the bore where the patient is located. As shown in the example of FIG. 8 , each of the scintillator sections or sheets may have a corresponding camera with a field of view covering it (shown approximately by the dotted lines). The number and disposition of the cameras and their fields of view in FIG. 8 are examples only and other configurations are contemplated. For example, the fields of view can cover only a portion of a section rather than an entire section, the cameras can be located at any axial location along the bore, and they can be on either side of the scintillator.

In some embodiments, a support structure can be configured to be mounted to the bore, and the one or more cameras can be fixed to the support structure. In the present example, a support structure configured to be mounted to the bore may include a cylindrical framework that generally conforms to the shape of the bore, such that the supporting structure having the cameras can be inserted or installed in the bore, without the need to mount individual cameras to the bore structure itself. In such embodiments, and other embodiments, such as those described above with reference to FIG. 8 , the cameras can be oriented to view respective portions of the scintillator adjacent to the cameras. Here, the scintillator “adjacent the camera” means the scintillator can be located at least partially at the same angular location as the camera. In addition to mounting cameras on such a support structure, other embodiments can include having the scintillator also mounted to the support structure. Such embodiments can allow for the entire assembly of scintillators and cameras to be inserted or mounted to the bore as a unit, rather than as individual components.

In other embodiments, the camera can be mounted to view a portion (i.e., some or all) of a radiation pattern displayed at a computer monitor showing radiation that was delivered to the radiation detector. The camera can be located at any position, for example, attached to the computer monitor via a mounting arm, mounted to a table or wall near the computer monitor, etc. As such, the camera can have any viewing angle relative to the computer monitor.

Accordingly, the disclosure of the present, and parent, applications contemplate, among other things, the general concepts of acquiring images during delivery of a radiation beam, the images capturing at least a portion of a shape representative of a radiation pattern generated by a radiation delivery system that includes a radiation source configured to deliver the radiation beam.

Thus, in addition to utilizing a scintillator to obtain images, the images can be of a computer monitor of a radiation detector, the operations further comprising determining one or more dimensions of the radiation pattern based on determining a conversion between the images and computer monitor images of the radiation pattern.

As explained further below, the present and parent disclosures thus also contemplate the utilization of the captured images and the calibration techniques described herein during treatment or as part of quality assurance, to perform, for example, dose calculation, collimator position determination (e.g., MLC leaf position), fluence determinations, etc. The captured images can be acquired from the camera aimed at a computer monitor displaying the shape that is representative of the radiation pattern. The camera may be mounted in a fixed relationship to the computer monitor by mounting to the computer monitor itself or another location nearby. To allow for a user to be in front of the monitor, it is contemplated that in some implementations the images can be acquired at an angle not perpendicular to the computer monitor. In some implementations, the camera can be fixed to the computer monitor so that the camera will be at an angle of between 1 and 10 degrees relative to a screen of the computer monitor (with 90 degrees being perpendicular to the screen). In other implementations, the camera can be is fixed to the computer monitor so that the camera will be at an angle of between 4 and 8 degrees relative to the screen of the computer monitor. In some implementations to have a more direct viewing of the computer monitor, the camera can be fixed at a location that maximizes the angle between the camera and the screen. For example, the location can be a wall generally opposite the monitor.

FIG. 8A illustrates an example of how the size of a radiation pattern may vary when captured by a camera viewing a computer monitor (or by screen capture at the computer monitor). The dimensions provided in the example are only for illustrative purposes and are not to scale. For example, a collimator can be controlled to form an aperture of 8 cm×8 cm. Due to beam divergence and based on distances along the beam axis, this aperture can result in a radiation pattern of 9 cm×9 cm at the isocenter and 10 cm×10 cm further along at the radiation detector. The radiation pattern, as displayed at the computer monitor (i.e., the “computer monitor image,” could be 800 pixels×800 pixels. If a screen capturing technique is used, the captured images of the radiation pattern could be, for example, 400 pixels×400 pixels. Similarly, if using a camera, due to factors including distance, offset, rotation, viewing angle, etc., the captured images from the camera could be rotated, skewed, magnified, offset, etc. When the images are corrected in software, they can then have the same shape as the radiation pattern (e.g., square), but with their final size in pixels depending on the final transformations used. However, with corrections/conversions, the images can be used to derive dimensions of radiation patterns and/or collimator positions, etc.

The present disclosure provides several methods for determining dimensions of a radiation pattern, positions of a collimator used to shape the radiation field, etc. As described herein, computer monitor images may be captured by a camera or with screen capture software. As previously illustrated in FIG. 8A, a complicating factor can be that the camera (and screen capture software) may generate images having a different resolution. Thus, the present disclosure provides implementations of methods and software algorithms to establish a conversion for the camera or screen capture images to provide a measure of the actual dimensions of the radiation pattern at the radiation detector (or other useful locations). Thus, in general, the software that performs this conversion (also referred to as “image processing module”) can determine a conversion between the captured images and the radiation pattern.

In some implementations, the image processing module can receive conversion information entered by a user after measuring the geometric relationship between the camera and the computer monitor. In other implementations, conversion information can be determined based on utilizing imaging of markers placed at known locations. In yet other implementations, conversion information can be determined that establishes a relationship between image intensity and delivered dose.

In other embodiments, the relationship between the pixels size of the displayed image and the radiation detector can be established by the original equipment manufacturer (OEM) a priori. In such circumstances, this calibration process can become a quality assurance process to confirm this relationship is as stated by the OEM.

Information for conversion of camera images received by the image processing module can include: camera angle (which can introduce a different conversion of the horizontal (X) and vertical (Y) pixels in the camera image), distance between the camera and the computer monitor, magnification of the images, offset between the center of the camera's FOV and the center of the viewing field at the computer monitor (i.e., the center of the camera image of the computer monitor not coinciding with the location at the radiation detector of the axis of the radiation beam), the angle of the camera, etc. Other factors that can be considered are the refresh rate of the computer monitor, the frame rate of the camera, either (or both) of which can result in image blurring or missing data. In this way, the operations for determining the conversion can include applying one or more of a scaling, rotation, or skew correction to the images.

Described below are exemplary methods for use with a camera imaging the radiation detector's computer monitor. Then, other exemplary methods are described for directly capturing the output of the computer monitor without the use of a camera.

First, a predefined radiation field can be created that has known dimensions. For example, a collimator can be controlled to have an aperture 8 cm×8 cm. The camera can then acquire images of the resultant radiation pattern at a scintillator or from the computer monitor. In software, the conversion between pixels in the camera image and the known size of the aperture can be established as a calibration for the camera images. Thus, when imaging a radiation field of unknown or varying dimensions, this calibration can be applied to convert the camera images into actual dimensions of the aperture. Similarly, with a known beam divergence and distance from the collimator to the radiation detector, isocenter, or any other location, the images can then be converted or used to measure the radiation field at those locations as well.

In another implementation, a graticule or other structure having markers representing known distance(s) and/or having known thicknesses can be placed at any location (e.g., on the radiation detector, at the isocenter, on the scintillator, etc.) and imaged. The markers can attenuate the beam and aid in determining image calibrations, as described further below.

In some implementations, acquiring of images can be performed by screen capture of the computer monitor displaying the shape representative of the radiation pattern. Such implementations have advantages in that additional hardware (e.g., a camera) is not required, which eliminates error that could be introduced by uncertainty in a camera angle or position. Described below are some factors that can be implemented in determining conversions utilizing images acquired through screen capture.

In one implementation, the conversion can be based on a ratio of pixels in the computer monitor images to the pixels in the acquired images. In another implementation, calibration methods similar to those discussed above can be performed where a radiation pattern of known dimension is projected onto the radiation detector. With known dimensions of the radiation pattern in pixels in the captured images, a conversion factor can be established. Thus, determining the conversion can include applying a scaling (likely) or rotation (if applicable). The scaling or rotation can utilize information entered by a user.

Based on the present disclosure relating to use of cameras or screen capture software to obtain images of and calculate dimensions associated with a radiation pattern, the following example of use is provided. One such method can include the following steps (though not limited to the order shown below):

-   -   Step 1—placing a graticule with markers that have known         thicknesses and/or known dimensions between the markers. The         markers can be made of one material or of different materials of         similar or varying radiation attenuation. In this way, the         markers will be visible in images due to being opaque to         delivered radiation.     -   Step 2—initiating delivery of a radiation beam.     -   Step 3—imaging the graticule with the radiation detector (e.g.,         an EPID) during delivery of the radiation beam.     -   Step 4—acquiring images during the delivery of the radiation         beam, the images capturing at least a portion of the graticule         (e.g., from a computer monitor).     -   Step 5—determining a conversion factor based on at least the         known dimensions of the graticule and the acquired images.

In some implementations, the method can also include obtaining the images of a computer monitor with a camera aimed at the computer monitor or with screen capture of the computer monitor.

Methods and software that enable the determination of MLC leaf positions are disclosed herein. Leaf positions can be reflected in scintillator radiation patterns imaged by one or more cameras, as described above. In one embodiment, leaf position determination can be facilitated by analyzing the edges of radiation patterns. As used herein, “radiation pattern” means the image of (or data representing the image of) scintillator light emitted due to interaction between the scintillator and a radiation beam.

As illustrated by the example in FIG. 9 , computer software can perform operations to determine edges of a radiation pattern. For example, at 910, using the image data acquired from the camera(s), an edge detection algorithm (e.g., a Canny edge detection algorithm) can be applied to a radiation pattern present in the images. The edge detection algorithm can determine at least one edge of the radiation pattern corresponding to a leaf of a multi-leaf collimator. From this, at 1020, a leaf position can be determined based at least on a location of the determined edge. Following this determination, it is possible to compare leaf positions during delivery of the radiation beam with planned leaf positions (e.g., as dictated by a radiation therapy plan and/or detailed in system log files). The comparison can thus be utilized in radiation therapy quality assurance. Determining leaf position at isocenter (FIG. 10 )

The process of determining leaf positions can then include, for example, compensating for image distortion caused by (or inherently present in) a given camera or camera system. For example, lens aberrations, and camera placement with respect to the scintillator can be accounted for. One method of accounting for optical effects from the camera system can include performing a calibration procedure with a well-known pattern that allows for a mapping of points in the image acquired by the camera to real positions in the object plane (e.g., the plane of a planar scintillator sheet). This correction/mapping can be performed for any number of opposing leaves of the MLC.

As part of radiation therapy quality assurance, it can be desired to determine leaf positions at a plane through the isocenter. One method for doing so can include determining the effective size of an opening between collimator leaves at a plane parallel to the isocenter plane. Then, the effective MLC leaf positions at the isocenter plane can be determined based on the effective size, when geometrically extended to the isocenter plane.

An exemplary arrangement of a simplified system used for the above determination is illustrated in FIG. 10 . Here, an example of a tilted scintillator 1010 is shown with a camera 1020 imaging the scintillator 1010. The radiation from radiation source 1005 passing through the MLC 1025 results in a radiation pattern at the scintillator. The shape of the radiation pattern is a length (length_(screen)) 1030 that corresponds to the size of the opening between MLC leaves (which can be directly related to the position of the MLC leaves). One exemplary formula for determining the length (length_(pp)) 1040 at on a plane parallel 1050 to the isocenter plane 1092 can be expressed as shown in Eq. 1, below.

$\begin{matrix} {{length}_{pp} = {\sqrt{{length}_{screen}^{2} - {height}^{2}} + \frac{X}{\left( {d_{1} + {height}} \right)}}} & (1) \end{matrix}$ ${length}_{pp} = {\sqrt{{length}_{screen}^{2} - {height}^{2}} + {\frac{X}{\left( {d_{1} + {height}} \right)}.}}$

In Eq. 1, the height is the height 1060 of the radiation pattern as measured in the vertical direction (or parallel to the beam axis). X is the X-coordinate 1070 of the right edge of the radiation pattern. d1 (element 1080) is the height from the radiation source to the plane parallel to the isocenter plane. The expanded view on the right side of FIG. 10 illustrates that length_(pp) 1040 can be found by accounting for the vertical projection 1042 of the radiation pattern to the plane parallel 1050. Once length_(pp) is found the length (length_(iso)) 1090 at the isocenter plane 1092 can be determined according to the following relation:

$\begin{matrix} {{length}_{iso} = {\frac{d_{2}}{d_{1}}{{length}_{pp}.}}} & (2) \end{matrix}$

In Eq. 2, d₂ (element 1095) is the distance from the radiation source to the isocenter plane 1092. The above description and solution of the simplified geometrical arrangement of the scintillator and camera system should not be considered limiting or exclusive of other solutions that may be implemented for embodiments described herein. Furthermore, it is readily apparent that the above disclosure for a flat scintillator can apply to any flat surface or its equivalent, for example, the above-described computer monitor or image files obtained via screen capture of the computer monitor.

The methods and operations described herein can further enable the determination of fluence maps at the isocenter plane, which can be useful for performing radiation therapy quality assurance. For example, the present disclosure contemplates software that can perform operations that include calculating a fluence map based at least on the leaf positions determined using the scintillator and also on beam output data obtained from the radiation therapy system. Furthermore, operations such as calculating a dose at a target location based at least on the fluence map and a patient image obtained from an imaging system may also be performed. Fluence maps, dose calculations, collimator shapes/MLC leaf positions, and other quantities that can be derived with the benefit of the disclosure herein are also described in commonly owned patent applications: U.S. patent application Ser. No. 14/694,865 (now U.S. Pat. No. 10,617,891) “Radiation detector Calibration” and U.S. patent application Ser. No. 15/395,852 “Determination Of Radiation Collimator Component Position,” the disclosures of which are incorporated by reference in their entirety.

Below is one example of a method of calibrating the disclosed radiation detector monitoring system to allow accurate determination of delivered dose at the radiation detector. This example allows the user to establish a relationship between the dose delivered by the RT system and the intensity of the pixels as seen on the monitor and the image acquired by the radiation detector. The exemplary method can include any or all of the following steps, not all of which need be performed in the order shown.

-   -   Step 1—The user can deliver a series of fixed (e.g., square or         rectangular) radiation patterns, each pattern at a different         dose level.     -   Step 2—For each radiation pattern, the user can enable recording         of the monitor screen by the camera or screen capturing via the         software interface to the radiation detector system.     -   Step 3—The user can turn the beam off and stop the camera or         screen capturing software.     -   Step 4—The camera or screen capturing software can write out a         file containing a video of the screen during image acquisition.     -   Step 5—The user can open the video file and measure the pixel         intensity via software. This can be a statistical measure such         as the average or median intensity in an area of the radiation         pattern.     -   Step 6—The user can enter the dose level for that radiation         pattern thus establishing a relationship between the pixel         intensity and the delivered dose from the radiation therapy         system.     -   Step 7—The user can repeat this process for all fields referred         to in Step 1.     -   Step 8—The dose calibration can then be saved for use during         treatment or later quality assurance. In some implementations,         the method may be used in conjunction with the processes         described in U.S. patent application Ser. No. 14/694,865 (now         U.S. Pat. No. 10,617,891) and U.S. patent application Ser. No.         15/395,852.

A further example of use is provided, describing a clinical treatment workflow. The exemplary method can include any or all of the following steps, not all of which need be performed in the order shown.

-   -   Step 1—The user can set the patient up for treatment and ready         the radiotherapy delivery system for treatment.     -   Step 2—The user can manually start video acquisition of the         monitor by the camera or screen capturing software. Acquisition         may occur continuously, and an image processing module (i.e., a         collection of software operations and processors utilized for         image processing) automatically processes the captured video         files into segments in which the beam was being delivered at         various points in the treatment.     -   Step 3—The user can initiate beam delivery and the RT delivery         system can deliver all treatment beams to the patient.     -   Step 4—Treatment ends and the user can stop video acquisition of         the monitor by the camera or screen capturing software.     -   Step 5—The camera or screen capturing software can write out a         file containing a video of the monitor during image acquisition.     -   Step 6—The image processing system can automatically process the         video file. This can be achieved by a software routine that         monitors the folder in which the video files are saved.     -   Step 6a—Alternately, the user can manually transfer the video         file to a predefined location or opens the video file directly         in the image processing system.     -   Step 7—The image processing system inputs the video file into a         software module (e.g., an image processing module) containing         the algorithm as defined herein or by either of U.S. patent         application Ser. No. 14/694,865 (now U.S. Pat. No. 10,617,891)         and U.S. patent application Ser. No. 15/395,852. The software         module can compute the leaf positions as function of time during         delivery. This information can be used to generate a DICOM RT         Plan object that can be used for dose computation.

In the following, further features, characteristics, and exemplary technical solutions of the present disclosure will be described in terms of items that may be optionally claimed in any combination:

-   -   Item 1: A computer program product comprising a non-transitory,         machine-readable medium storing instructions which, when         executed by at least one programmable processor, cause the at         least one programmable processor to perform operations         comprising: acquiring images during delivery of a radiation         beam, the images capturing at least a portion of a shape         representative of a radiation pattern generated by a radiation         delivery system that includes a radiation source configured to         deliver the radiation beam.     -   Item 2: The computer program product of item 1, wherein the         images are acquired from a camera aimed at a computer monitor         displaying the shape representative of the radiation pattern.     -   Item 3: The computer program product of any one of the preceding         items, wherein the camera is mounted in a fixed relationship to         the computer monitor by mounting to the computer monitor itself         or to another location nearby.     -   Item 4: The computer program product of any one of the preceding         items, wherein the camera is fixed to the computer monitor so         that the camera will be at an angle of between 1 and 10 degrees         relative to a screen of the computer monitor.     -   Item 5: The computer program product of any one of the preceding         items, wherein the camera is fixed to the computer monitor so         that the camera will be at an angle of between 4 and 8 degrees         relative to the screen of the computer monitor.     -   Item 6: The computer program product of any one of the preceding         items, wherein the camera is fixed at a location that maximizes         the angle between the camera and the screen.     -   Item 7: The computer program product of any one of the preceding         items, wherein the location is a wall generally opposite the         monitor.     -   Item 8: The computer program product of any one of the preceding         items, wherein the images are acquired at an angle not         perpendicular to the computer monitor.     -   Item 9: The computer program product of any one of the preceding         items, the operations further comprising receiving conversion         information entered by a user after measuring a geometric         relationship between the camera and the computer monitor.     -   Item 10: The computer program product of any one of the         preceding items, the operations further comprising determining         conversion information based on utilizing imaging of markers         placed at known locations.     -   Item 11: The computer program product of any one of the         preceding items, the operations further comprising determining         conversion information that establishes a relationship between         image intensity and delivered dose.     -   Item 12: The computer program product of any one of the         preceding items, the operations further comprising: applying an         edge detection algorithm to a radiation pattern present in the         images, the edge detection algorithm determining at least one         edge of the radiation pattern corresponding to a leaf of a         multi-leaf collimator; and determining a leaf position based at         least on a location of the determined edge.     -   Item 13: The computer program product of any one of the         preceding items, the operations further comprising comparing the         leaf position during delivery of the radiation beam with a         planned leaf position, the comparing utilized in radiation         therapy quality assurance.     -   Item 14: The computer program product of any one of the         preceding items, the operations further comprising calculating a         fluence map based at least on the leaf position and beam output         data obtained from the radiation therapy system.     -   Item 15: The computer program product of any one of the         preceding items, the operations further comprising calculating a         dose at a target location based at least on the fluence map and         a patient image obtained from an imaging system.     -   Item 16: The computer program product of any one of the         preceding items, wherein the dose is a three-dimensional dose         delivered at the target location.     -   Item 17: The computer program product of any one of the         preceding items, wherein the acquiring is performed by screen         capture of a computer monitor displaying the shape         representative of the radiation pattern.     -   Item 18: A method comprising: placing a graticule with markers         that have known dimensions between the markers; initiating         delivery of a radiation beam; imaging the graticule with the         radiation detector during delivery of the radiation beam;         acquiring images, the images capturing at least a portion of the         graticule; and determining a conversion factor based on at least         the known dimensions of the graticule and the acquired images.     -   Item 19: The method of Item 18, wherein the acquiring of images         comprises obtaining images of a computer monitor with a camera         aimed at the computer monitor or with screen capture of the         computer monitor.     -   Item 20: A system comprising: at least one programmable         processor; and a non-transitory machine-readable medium storing         instructions which, when executed by the at least one         programmable processor, cause the at least one programmable         processor to perform operations comprising those of any of items         1-17.

The present disclosure contemplates that the calculations disclosed in the embodiments herein may be performed in a number of ways, applying the same concepts taught herein, and that such calculations are equivalent to the embodiments disclosed.

One or more aspects or features of the subject matter described herein can be realized in digital electronic circuitry, integrated circuitry, specially designed application specific integrated circuits (ASICs), field programmable gate arrays (FPGAs) computer hardware, firmware, software, and/or combinations thereof. These various aspects or features can include implementation in one or more computer programs that are executable and/or interpretable on a programmable system including at least one programmable processor, which can be special or general purpose, coupled to receive data and instructions from, and to transmit data and instructions to, a storage system, at least one input device, and at least one output device. The programmable system or computing system may include clients and servers. A client and server are generally remote from each other and typically interact through a communication network. The relationship of client and server arises by virtue of computer programs running on the respective computers and having a client-server relationship to each other.

These computer programs, which can also be referred to programs, software, software applications, applications, components, or code, include machine instructions for a programmable processor, and can be implemented in a high-level procedural language, an object-oriented programming language, a functional programming language, a logical programming language, and/or in assembly/machine language. As used herein, the term “machine-readable medium” (or “computer readable medium”) refers to any computer program product, apparatus and/or device, such as for example magnetic discs, optical disks, memory, and Programmable Logic Devices (PLDs), used to provide machine instructions and/or data to a programmable processor, including a machine-readable medium that receives machine instructions as a machine-readable signal. The term “machine-readable signal” (or “computer readable signal”) refers to any signal used to provide machine instructions and/or data to a programmable processor. The machine-readable medium can store such machine instructions non-transitorily, such as for example as would a non-transient solid-state memory or a magnetic hard drive or any equivalent storage medium. The machine-readable medium can alternatively or additionally store such machine instructions in a transient manner, such as for example as would a processor cache or other random access memory associated with one or more physical processor cores.

To provide for interaction with a user, one or more aspects or features of the subject matter described herein can be implemented on a computer having a display device, such as for example a cathode ray tube (CRT) or a liquid crystal display (LCD) or a light emitting diode (LED) monitor for displaying information to the user and a keyboard and a pointing device, such as for example a mouse or a trackball, by which the user may provide input to the computer. Other kinds of devices can be used to provide for interaction with a user as well. For example, feedback provided to the user can be any form of sensory feedback, such as for example visual feedback, auditory feedback, or tactile feedback; and input from the user may be received in any form, including, but not limited to, acoustic, speech, or tactile input. Other possible input devices include, but are not limited to, touch screens or other touch-sensitive devices such as single or multi-point resistive or capacitive trackpads, voice recognition hardware and software, optical scanners, optical pointers, digital image capture devices and associated interpretation software, and the like.

In the descriptions above and in the claims, phrases such as “at least one of” or “one or more of” may occur followed by a conjunctive list of elements or features. The term “and/or” may also occur in a list of two or more elements or features. Unless otherwise implicitly or explicitly contradicted by the context in which it used, such a phrase is intended to mean any of the listed elements or features individually or any of the recited elements or features in combination with any of the other recited elements or features. For example, the phrases “at least one of A and B;” “one or more of A and B;” and “A and/or B” are each intended to mean “A alone, B alone, or A and B together.” A similar interpretation is also intended for lists including three or more items. For example, the phrases “at least one of A, B, and C;” “one or more of A, B, and C;” and “A, B, and/or C” are each intended to mean “A alone, B alone, C alone, A and B together, A and C together, B and C together, or A and B and C together.” Use of the term “based on,” above and in the claims is intended to mean, “based at least in part on,” such that an unrecited feature or element is also permissible.

The subject matter described herein can be embodied in systems, apparatus, methods, computer programs and/or articles depending on the desired configuration. Any methods or the logic flows depicted in the accompanying figures and/or described herein do not necessarily require the particular order shown, or sequential order, to achieve desirable results. The implementations set forth in the foregoing description do not represent all implementations consistent with the subject matter described herein. Instead, they are merely some examples consistent with aspects related to the described subject matter. Although a few variations have been described in detail above, other modifications or additions are possible. In particular, further features and/or variations can be provided in addition to those set forth herein. The implementations described above can be directed to various combinations and subcombinations of the disclosed features and/or combinations and subcombinations of further features noted above. Furthermore, above described advantages are not intended to limit the application of any issued claims to processes and structures accomplishing any or all of the advantages.

Additionally, section headings shall not limit or characterize the invention(s) set out in any claims that may issue from this disclosure. Further, the description of a technology in the “Background” is not to be construed as an admission that technology is prior art to any invention(s) in this disclosure. Neither is the “Summary” to be considered as a characterization of the invention(s) set forth in issued claims. Furthermore, any reference to this disclosure in general or use of the word “invention” in the singular is not intended to imply any limitation on the scope of the claims set forth below. Multiple inventions may be set forth according to the limitations of the multiple claims issuing from this disclosure, and such claims accordingly define the invention(s), and their equivalents, that are protected thereby. 

What is claimed is:
 1. A computer program product comprising a non-transitory, machine-readable medium storing instructions which, when executed by at least one programmable processor, cause the at least one programmable processor to perform operations comprising: acquiring images during delivery of a radiation beam, the images capturing at least a portion of a shape representative of a radiation pattern generated by a radiation delivery system that includes a radiation source configured to deliver the radiation beam, the acquiring comprising performing a screen capture of a computer monitor displaying the shape representative of the radiation pattern.
 2. The computer program product of claim 1, the operations further comprising determining the dimensions of the radiation pattern at the radiation detector from the screen capture.
 3. The computer program product of claim 1, the operations further comprising determining collimator positions from the screen capture.
 4. The computer program product of claim 1, the operations further comprising determining a conversion between the images and the radiation pattern.
 5. The computer program product of claim 4, the operations further comprising determining conversion information based on utilizing imaging of markers placed at known locations.
 6. The computer program product of claim 1, the operations further comprising: controlling the radiation delivery system to project a radiation pattern of known dimensions onto a radiation detector; and determining a conversion factor using known dimensions of the radiation pattern in pixels in the images.
 7. The computer program product of claim 6, wherein determining the conversion factor includes scaling.
 8. The computer program product of claim 6, wherein determining the conversion factor includes rotation.
 9. The computer program product of claim 1, the operations further comprising: applying an edge detection algorithm to a radiation pattern present in the images, the edge detection algorithm determining at least one edge of the radiation pattern corresponding to a leaf of a multi-leaf collimator; and determining a leaf position based at least on a location of the determined edge.
 10. The computer program product of claim 9, the operations further comprising comparing the leaf position during delivery of the radiation beam with a planned leaf position, the comparing utilized in radiation therapy quality assurance.
 11. The computer program product of claim 10, the operations further comprising calculating a fluence map based at least on the leaf position and beam output data obtained from the radiation therapy system.
 12. The computer program product of claim 11, the operations further comprising calculating a dose at a target location based at least on the fluence map and a patient image obtained from an imaging system.
 13. The computer program product of claim 12, wherein the dose is a three-dimensional dose delivered at the target location.
 14. The computer program product of claim 1, the operations further comprising determining conversion information that establishes a relationship between image intensity and delivered dose.
 15. A system comprising: at least one programmable processor; and a non-transitory machine-readable medium storing instructions which, when executed by the at least one programmable processor, cause the at least one programmable processor to perform operations comprising: acquiring images during delivery of a radiation beam, the images capturing at least a portion of a shape representative of a radiation pattern generated by a radiation delivery system that includes a radiation source configured to deliver the radiation beam, the acquiring comprising performing a screen capture of a computer monitor displaying the shape representative of the radiation pattern.
 16. The system of claim 15, the operations further comprising determining the dimensions of the radiation pattern at the radiation detector from the screen capture.
 17. The system of claim 15, the operations further comprising determining collimator positions from the screen capture.
 18. The system of claim 15, the operations further comprising determining a conversion between the images and the radiation pattern.
 19. The system of claim 15, the operations further comprising: controlling the radiation delivery system to project a radiation pattern of known dimensions onto a radiation detector; and determining a conversion factor using known dimensions of the radiation pattern in pixels in the images.
 20. The system of claim 15, the operations further comprising determining conversion information that establishes a relationship between image intensity and delivered dose. 